Carette S, Urowitz M B, Grosman H, St Louis E L
J Rheumatol. 1982 Nov-Dec;9(6):855-9.
Twelve patients with active central nervous system systemic lupus erythematosus (CNS SLE) and 11 patients without CNS involvement, all taking corticosteroids, were studied by computerized tomography (CT). Thirty CT scans on 23 individuals were performed and read blindly and independently by 2 neuroradiologists with an 86% correlation. Minimal to moderate atrophy was the most frequent finding, both in CNS SLE and controls, severe atrophy seen in 1 patient only, and no atrophy in 3 patients and a single control. Of the 6 patients who had repeated scans, 4 showed no change in the degree of atrophy, 1 had more and 1 less atrophy. Three patients had evidence of multiple brain infarcts on scan with or without associated cerebral atrophy. Sequential scans in 1 of these patients showed total resolution of the infarcts after 30 months. Thus, there was no correlation between the presence of cerebral atrophy on CT scan and CNS SLE. Rather our findings suggest that steroids may be the cause of atrophy.
对12例患有活动性中枢神经系统系统性红斑狼疮（CNS SLE）且正在服用皮质类固醇的患者以及11例无中枢神经系统受累且同样正在服用皮质类固醇的患者进行了计算机断层扫描（CT）研究。对23名个体进行了30次CT扫描，并由2名神经放射科医生进行盲法独立阅片，二者的阅片结果相关性为86%。轻度至中度萎缩是最常见的表现，在CNS SLE患者和对照组中均如此，仅1例出现严重萎缩，3例患者和1例对照未出现萎缩。在6例进行了重复扫描的患者中，4例萎缩程度无变化，1例萎缩加重，1例萎缩减轻。3例患者的扫描显示有多发脑梗死证据，伴有或不伴有相关脑萎缩。其中1例患者的连续扫描显示30个月后梗死灶完全消失。因此，CT扫描显示的脑萎缩与CNS SLE之间无相关性。相反，我们的研究结果提示类固醇可能是萎缩的原因。
